insurance

[Guest guest]

Your bill from was $24,000?????? It was my understanding that the

$17,000 that Dr. R was " charging " was an all-inclusive price - meaning

no bill from anyone else. That is what I have told people.

in GA

Insurance

Hi - Just an FYI for those of you who have BC/BS of any state that

will cover MGB's!!

I have BC/BS of Michigan and had MGB with Dr R on 01/07/2002 - I was

preauthorized and per usual am still fighting with BC/BS of Michigan for

payment. I am 3 1/2 months post-operative and I just got a check for Dr

R.

I called BC/BS of Michigan and this is my understanding of what they

are going to pay.

First, Dr Rutledge is out-of-network - so make sure you have a letter of

referral from your MD and they should pay Dr R as if he is in network. I

got a check for $905.00 and they approved $2,500.00 - so I should be

getting another check for about $1,600.00. I sent them the receipt from

Dr R's office for $17,000.00 with the letter Dr R provides with the

CPT-4 codes.

Then, I sent them a copy of my itemized bill from Regional

Medical Center for $24,000.00 and we will see what they pay - I am

hoping for about $14,000.00 - which would mean that they would reimburse

around $16,000.00 of the $17,000.00 bill. That would make me a very

happy camper!

I guess we will just have to wait and see.

Carol H

Dr R - MGB- 01/07/2002

268/242/228/215/209

[Guest guest]

,

Relax- the global bill is only $17,000.00 and that is what I paid BUT

BC/BS wants seperate itemized bills and so - you send them the global bill

from Dr R and then they want an itemized hospital bill. It does not really

matter how much the bill is because BC/BS has only certain amounts that they

reimburse for services no matter how much the bill is.

But YES the bill you receieve from Medical Center is $24,000.00- but

remember you have already paid this bill.

Carol

Insurance

>

>

> Hi - Just an FYI for those of you who have BC/BS of any state that

> will cover MGB's!!

>

> I have BC/BS of Michigan and had MGB with Dr R on 01/07/2002 - I was

> preauthorized and per usual am still fighting with BC/BS of Michigan for

> payment. I am 3 1/2 months post-operative and I just got a check for Dr

> R.

>

> I called BC/BS of Michigan and this is my understanding of what they

> are going to pay.

> First, Dr Rutledge is out-of-network - so make sure you have a letter of

> referral from your MD and they should pay Dr R as if he is in network. I

> got a check for $905.00 and they approved $2,500.00 - so I should be

> getting another check for about $1,600.00. I sent them the receipt from

> Dr R's office for $17,000.00 with the letter Dr R provides with the

> CPT-4 codes.

>

> Then, I sent them a copy of my itemized bill from Regional

> Medical Center for $24,000.00 and we will see what they pay - I am

> hoping for about $14,000.00 - which would mean that they would reimburse

> around $16,000.00 of the $17,000.00 bill. That would make me a very

> happy camper!

>

> I guess we will just have to wait and see.

>

>

> Carol H

> Dr R - MGB- 01/07/2002

> 268/242/228/215/209

>

>

>

>

>

>

[Guest guest]

That is a relief ---- I was going to say that if it really was $41,000

then it costs as much as the RNY! I know that Durham Regional only got

about $1000 for the $11,000 that they billed CIGNA for me.

in GA

Re: Insurance

,

Relax- the global bill is only $17,000.00 and that is what I paid

BUT

BC/BS wants seperate itemized bills and so - you send them the global

bill

from Dr R and then they want an itemized hospital bill. It does not

really

matter how much the bill is because BC/BS has only certain amounts that

they

reimburse for services no matter how much the bill is.

But YES the bill you receieve from Medical Center is $24,000.00-

but

remember you have already paid this bill.

Carol

Insurance

>

>

> Hi - Just an FYI for those of you who have BC/BS of any state that

> will cover MGB's!!

>

> I have BC/BS of Michigan and had MGB with Dr R on 01/07/2002 - I

was

> preauthorized and per usual am still fighting with BC/BS of Michigan

for

> payment. I am 3 1/2 months post-operative and I just got a check for

Dr

> R.

>

> I called BC/BS of Michigan and this is my understanding of what

they

> are going to pay.

> First, Dr Rutledge is out-of-network - so make sure you have a letter

of

> referral from your MD and they should pay Dr R as if he is in network.

I

> got a check for $905.00 and they approved $2,500.00 - so I should be

> getting another check for about $1,600.00. I sent them the receipt

from

> Dr R's office for $17,000.00 with the letter Dr R provides with the

> CPT-4 codes.

>

> Then, I sent them a copy of my itemized bill from Regional

> Medical Center for $24,000.00 and we will see what they pay - I am

> hoping for about $14,000.00 - which would mean that they would

reimburse

> around $16,000.00 of the $17,000.00 bill. That would make me a very

> happy camper!

>

> I guess we will just have to wait and see.

>

>

> Carol H

> Dr R - MGB- 01/07/2002

> 268/242/228/215/209

>

>

>

>

>

>

[Guest guest]

That is INCREDIBLE NEWS! I'm so happy to hear it cause I know MANY have

BCBS! That has to give some hope.

in OK

MGB 3/29/2001

[Guest guest]

It is my understanding that he is not " taking " any insurance. If you

can get your insurance company to pay either him or the hospital, etc.

that is great -- but the total amount of $17,000 is still what will be

due regardless of what the insurance company pays. There are other MGB

surgeons other there that apparently do take insurance though.

in GA

insurance

And is Rutledge taking any insurance?

_________________________________________________________________

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[Guest guest]

No insurance. Money up front only.

[Guest guest]

,

I'm having the same problem with BC/BS of Pennsylvania. I live in Virginia

and sent a letter to the commissioner, but they forwarded it to Pennsylvania.

I don't understand why they won't pay the global billing. It is accepted

with prenantal patients.

Connie(Va)

[Guest guest]

I have never seen " global billing " for prenatal patients except for the

physician's fees.... I think the problem here is that the " global bill "

includes the hospital, the anesthesiologist, etc.

Good luck!

in GA

> Re: Insurance

>

>

> ,

>

> I'm having the same problem with BC/BS of Pennsylvania. I

> live in Virginia

> and sent a letter to the commissioner, but they forwarded it

> to Pennsylvania.

> I don't understand why they won't pay the global billing. It

> is accepted

> with prenantal patients.

>

> Connie(Va)

>

>

[Guest guest]

Hi Kat,

I know you are very disappointed and I already posted to you on

another list. The message bears repeating.

Appeal! Don't give up! You can win this!

Alice

> Hello everyone!

>

> Well, my waiting is over. It's not good news-they won't cover my

> implant I'm a little depressed now. I'd call and cry to hubby

> but he's in the field without his cellphone. I think I'm going to

go

> crawl in a hole now!

>

> Kat D in Wyoming

> Surgery July 4th

> waiting on insurance --got it & denied

> www.geocities.com/jandkdewitt/deafnesspg1.html

[Guest guest]

Kat,

I agree with Alice - appeal Appeal APPEAL!! Alice - isn't it true

that Kat can get help from Cochlear if she was planning to get the

Nucleus?

Nuked 9/28/00

Hooked 10/26/00

I SUPPORT OUR TROOPS!

[Guest guest]

What state are you in?

Connie

insurance

> Does anyone know of an insurance company that will accept a person

> with hepatitis c? Our insurance company, Mutual of Omaha will no

> longer write policies for major health and hospital after December 1,

> 2003. We would appreciate any help we can get. Terry

>

>

>

>

[Guest guest]

What state are you in?

Connie

insurance

> Does anyone know of an insurance company that will accept a person

> with hepatitis c? Our insurance company, Mutual of Omaha will no

> longer write policies for major health and hospital after December 1,

> 2003. We would appreciate any help we can get. Terry

>

>

>

>

[Guest guest]

I live in Folsom, Louisiana.

[Guest guest]

I live in Folsom, Louisiana.

[Guest guest]

Thanks for trying. I did get in touch with Louisiana Health plan for high

risk people. It covers $100,000.00 per calendar, which is not enough if

something serious happens to my husband or myself. We are looking for something

else, but as a last resort, it is better than nothing. Terry

[Guest guest]

Thanks for trying. I did get in touch with Louisiana Health plan for high

risk people. It covers $100,000.00 per calendar, which is not enough if

something serious happens to my husband or myself. We are looking for something

else, but as a last resort, it is better than nothing. Terry

[Guest guest]

I'm sorry. I don't know anything about Louisiana. In Texas, there is a

Texas Risk Pool that will cover hep c under certain circumstances. You

might want to get in contact with your Louisiana State Insurance Commission

to see if they have something like that.

Connie

Re: insurance

> I live in Folsom, Louisiana.

>

>

>

[Guest guest]

I'm sorry. I don't know anything about Louisiana. In Texas, there is a

Texas Risk Pool that will cover hep c under certain circumstances. You

might want to get in contact with your Louisiana State Insurance Commission

to see if they have something like that.

Connie

Re: insurance

> I live in Folsom, Louisiana.

>

>

>

[Guest guest]

also, In Texas at least, if you are working, and your employer's insurance

changes, they can't deny you coverage, or when you change jobs, if you sign up

in the allotted time.

Alley

SFF_Romance

SFF_Writers/

SFF_Texas

Texas_Writers/

DFW_Authors

AdultAuthors

Critical_Critters

writingandpublishing

critique_group

Art_Of_Texas

[Guest guest]

also, In Texas at least, if you are working, and your employer's insurance

changes, they can't deny you coverage, or when you change jobs, if you sign up

in the allotted time.

Alley

SFF_Romance

SFF_Writers/

SFF_Texas

Texas_Writers/

DFW_Authors

AdultAuthors

Critical_Critters

writingandpublishing

critique_group

Art_Of_Texas

[Guest guest]

Dear Terry: Best of luck to you. I was in a similar circumstance about

the time they decided I needed a liver transplant. They had quoted me a

price of about $350,000.00. We were really scared. Luckily, I was able to

get disability, which got me Medicare. I still haven't gotten the

transplant but at least I can pay for it now! Connie

Re: insurance

> Thanks for trying. I did get in touch with Louisiana Health plan for high

> risk people. It covers $100,000.00 per calendar, which is not enough if

> something serious happens to my husband or myself. We are looking for

something

> else, but as a last resort, it is better than nothing. Terry

>

>

>

[Guest guest]

Dear Terry: Best of luck to you. I was in a similar circumstance about

the time they decided I needed a liver transplant. They had quoted me a

price of about $350,000.00. We were really scared. Luckily, I was able to

get disability, which got me Medicare. I still haven't gotten the

transplant but at least I can pay for it now! Connie

Re: insurance

> Thanks for trying. I did get in touch with Louisiana Health plan for high

> risk people. It covers $100,000.00 per calendar, which is not enough if

> something serious happens to my husband or myself. We are looking for

something

> else, but as a last resort, it is better than nothing. Terry

>

>

>

[Guest guest]

, this is absolutely fascinating and highly informative. I would not have

known about Dr. Boachie's involvement in providing surgery for needy patients in

Ghana. Certainly everything I hear about some African countries these days makes

me wish that I had something to offer myself -- such horrendous suffering, so

many people living lives that we in the U.S. can scarcely begin to imagine.

I must admit I am still perplexed at the news that surgeons here are now taking

NO insurance. Is there still some way that patients can get reimbursed for

surgery through their carriers? How can a patient afford a standard surgical

fee without going broke for life? And so often patients already disabled by

spinal deformities are the least able to afford expensive operations to fix

their problems. This is deeply worrisome. Do you see any long-range solution?

Insurance

I don't know about other areas of the country, but more and more

physicians here in Northern California have stopped accepting

insurance. All of my (now ex) Stanford doctors stopped accepting

insurance several years ago. In each case, the letters they sent out

told me that they could not continue operating at a loss. In general,

if doctors offices are losing money (and I think that many are), then

I'd rather pay more out of my pocket, and still have access to good

healthcare. In any event, my insurance reimburses me for out of

network service, so my visits weren't completely out of my pocket.

In the case of Dr. Boachie, he travels to Ghana several times every

year, and to Barbados occasionally, to perform surgery on the most

needy of patients who would not otherwise have access to even poor

healthcare for their spinal deformities. The organization that he

founded is F.O.C.O.S. (http://orthofocos.org). Not that it's

necessarily justification for not accepting insurance, but I suspect

that this strategy allows him to fund F.O.C.O.S.

This is a topic which should be of interest to anyone who will require

expensive healthcare in the future. Physicians and hospitals will not

continue to operate if they can't make a profit. I obviously don't

have the answer, but hopefully something will be done before our

access to good healthcare goes away.

By the way, I'm sure most of you have seen evidence of how HMO/PPO

contracts reduce the amount paid, but I have one that really shocked

me. A hospital bill of $56,349.50 was reduced by Blue Shield PPO to

$7,737.00. Since it represented a week of inpatient care, I truly

doubt that the payment came close to paying the true costs.

--

Support for scoliosis-surgery veterans with Harrington Rod Malalignment

Syndrome. Not medical advice. Group does not control ads or endorse any

advertised products.

[Guest guest]

...

When one has PPO insurance, and is seen by a physician who doesn't

accept insurance, one can get partially reimbursed. I'm sure that

coverage varies, but in my PPO, if I go out of network, I have to pay

a deductible and coinsurance, neither of which I have to pay for in

network covered services.

--

[Guest guest]

Thanks for the clarification, .

Re: Insurance

...

When one has PPO insurance, and is seen by a physician who doesn't

accept insurance, one can get partially reimbursed. I'm sure that

coverage varies, but in my PPO, if I go out of network, I have to pay

a deductible and coinsurance, neither of which I have to pay for in

network covered services.

--

Support for scoliosis-surgery veterans with Harrington Rod Malalignment

Syndrome. Not medical advice. Group does not control ads or endorse any

advertised products.

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